COLD APPLICATION

Definition

Cold application is the application of cold agent, cooler than skin either in a moist or dry form on the surface of the body to relieve pain and body temperature, to anaesthetize an area , to check hemorrhage, to control growth of bacteria, to prevent edema and reduce inflammation.
Cold application is the application of cold agent, cooler than skin either in a moist or dry form on the surface of skin.

Purpose

To reduce raised body temperature during high fever & hyper pyrexia or sun stroke.
To relieve local pain(To anaesthetize an area)
Cold decrease prostaglandin’s which decreases the sensitivity of pain receptors, and other substances at the site of injury by inhibiting the inflammatory processes.
To reduce subcutaneous bleeding. Eg- in sprain & contusion.
To control bleeding. Eg- epistaxis.
To provide comfort to a patient in extreme hot weather if desired.
To reduce swelling and inflammation by decreasing the blood flow to the area (vasoconstriction effect).

General Principles of Cold Applications

Cold causes construction of blood vessels and decrease the blood supply to the area.
Cold decreases metabolism and the cell activity or growth.
The end organs of the sensory nerves in the skin convey the sensation of cold; the sensations are interpreted in the brain.
Woolen materials absorb moisture slowly, but hold moisture longer and colds off less quickly than the cotton materials.
Moisture left on the skin causes rapid cooling due to evaporation of the moisture.
Prolonged exposure to moisture increases the skins susceptibility to maceration and skin breakdown.
After the procedure, dry the part by patting and not by rubbing to remove the moisture.
During cold applications, protect the client from getting chills. Shivering can raise the temperature.
Sudden cooling is dangerous to a patient. So, in hyperthermia, the temperature should be brought down gradually and steadily.

Physiological effects.-

Therapeutic use of cold application-

Cold Relieves Pain -Cold decreases the nerve impulse conduction and relieves pain.
Prevents Gangrene- Cold decreases the tissue metabolism. Cold decreases the effects of tissue anoxia (oxygen lack) & thereby delay the tissue necrosis.
Prevents edema and reduces Inflammation- It decreases the blood circulation and prevent fluid congestion. Eg – sprains.
Controls Hemorrhage- it causes vasoconstriction & increases the blood viscosity which helps in the coagulation of the blood and checks hemorrhage.
Check the Growth of Bacteria -Cutaneous application of cold reduces the tissue temperature and makes the environment less favourable for the growth of the microorganisms.
Reduces the body Temperature - it is withdrawn from the body by conduction, convection and evaporation. Thus, the body temperature is reduced.
Cold Anaesthetize an Area - it decrease the sensitivity of tissues and creates a sensation of numbness. Thus it can be used as local anaesthesia for a short period.

Contraindications of Cold Application

Cold should not be applied on clients who are in a state of shock and collapse.
When there is edema.
In disease associated with impaired circulation. Eg – clients with diabetes, arteriosclerosis & neurological disorder.
When there is muscle spasm.
When there is decreased sensation. Eg- numbness
When there is infected wound which are to be dried of the pus or if we intend to promote suppuration.
When the client is having shivering of having a very low temperature.

Complications -

Classification of cold application

A. Local

B. General

Ice Bag -

EQUIPMENTS

Articles	purpose
Ice bag	To provide cold application
Bowel	To keep ice cube
Duster	To wipe the outside of the jug
Towel / ice bag cover	To insulate the coldwater bag
Lotion thermometer (if possible)	To check the temperature of the hot water
Makintosh	To protect the bed
A roll of tape or bandage	To secure the bag
Spoon	To take the ice pieces

Preliminary Assessment of the Patient

Steps of Procedure.

Steps	Rational
Break the ice into smalll pieces	For easy insertion of ice into bag.
Sprinkle sodium chloride	Salt lowers the melting point
Check the ice bag for leakage by pouring water into it	To ensure that the bag is in agood working condition.
Empty the bag and fill it about 2/3 or with ice.	This makes the bag light in weight.
Keep the bag on a flat surface and squeeze out the air.	Air is removed in order that the ice bag can be moulded to the patient’s body.
Screw the cap well and wipe it.	To ensure that the bag is not leaking.
Put on a flannel cover.	The cover retain cold for more gradual application and it absorbs the water formed by atmospheric condensation.
Explain the procedure to the patient.	To gain more co-operation.
Spread the mankintosh and the draw sheet.	To protect pillow cover and pillow
The ice bag is applied for about half and hour and then it is discontinued for atleast an hour for the recovery period.	To prevent the effect of prolonged exposure to cold
Chart the treatment and its effect.	Recording is important for any procedure.
Wash the icebag with water and dry it.	For re-use
Dry & then powder between the layers of the rubber and store after.	To store it properly

Aftyer Care of the Client and Articles.

Remove the ice bag when the treatment completed.
Dry the area if moist.
Position the client comfortably on bed.
Take all the articles to the utility room and replace all the articles.
Wash hands.
Records the procedures with dates and times, the area or where it is applied, the purpose of the application & the reaction if any.